Meta-analysis of the Effect of a Pulmonary Rehabilitation Program on Respiratory Muscle Strength in Patients with Chronic Obstructive Pulmonary Disease

Lee, Eun Nam; Kim, Moon Ja

doi:10.1016/j.anr.2018.11.005

Cited by 16 publications

(23 citation statements)

References 23 publications

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“…Lung function improved after 6 weeks of respiratory rehabilitation in a clinical trial conducted with older adults post‐COVID‐19 (Liu et al., 2020 ). Moreover, similar effects have been reported in patients with chronic obstructive pulmonary disease, indicating aerobic and resistance training improve respiratory muscles strength (Chiu et al., 2020 ; Lee & Kim, 2019 ). Therefore, increased ventilation provided by physical training may affect respiratory muscles, increasing oxidative fibers and oxidative enzyme activity (Decramer, 2009 ).…”

Section: Discussionsupporting

confidence: 71%

Effects of continuous aerobic training associated with resistance training on maximal and submaximal exercise tolerance, fatigue, and quality of life of patients post‐COVID‐19

Araújo

Barros

Nunes

et al. 2022

Physiotherapy Res Intl

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Background and Purpose Dyspnea, fatigue, and reduced exercise tolerance are common in post‐COVID‐19 patients. In these patients, rehabilitation can improve functional capacity, reduce deconditioning after a prolonged stay in the intensive care unit, and facilitate the return to work. Thus, the present study verified the effects of cardiopulmonary rehabilitation consisting of continuous aerobic and resistance training of moderate‐intensity on pulmonary function, respiratory muscle strength, maximum and submaximal tolerance to exercise, fatigue, and quality of life in post‐COVID‐19 patients. Methods Quasi‐experimental study with a protocol of 12 sessions of an outpatient intervention. Adults over 18 years of age ( N = 26) with a diagnosis of COVID‐19 and hospital discharge at least 15 days before the first evaluation were included. Participants performed moderate‐intensity continuous aerobic and resistance training twice a week. Maximal and submaximal exercise tolerance, lung function, respiratory muscle strength, fatigue and quality of life were evaluated before and after the intervention protocol. Results Cardiopulmonary rehabilitation improved maximal exercise tolerance, with 18.62% increase in peak oxygen consumption (VO2peak) and 29.05% in time to reach VO 2 peak. VE/VCO 2 slope reduced 5.21% after intervention. We also observed increased submaximal exercise tolerance (increase of 70.57 m in the 6‐min walk test, p = 0.001), improved quality of life, and reduced perceived fatigue after intervention. Discussion Patients recovered from COVID‐19 can develop persistent dysfunctions in almost all organ systems and present different signs and symptoms. The complexity and variability of the damage caused by this disease can make it difficult to target rehabilitation programs, making it necessary to establish specific protocols. In this work, cardiopulmonary rehabilitation improved lung function, respiratory muscle strength, maximal and submaximal exercise tolerance, fatigue and quality of life. Continuous aerobic and resistance training of moderate intensity proved to be effective in the recovery of post‐COVID‐19 patients.

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Section: Discussionsupporting

confidence: 71%

Effects of continuous aerobic training associated with resistance training on maximal and submaximal exercise tolerance, fatigue, and quality of life of patients post‐COVID‐19

Araújo

Barros

Nunes

et al. 2022

Physiotherapy Res Intl

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“…The inflammatory cytokines produced by COPD severely affect skeletal muscles throughout the whole body, including the diaphragm. In addition, tissue insufficient oxygen supply, electrolytic disorder further damages the diaphragm (Barreiro and Gea, 2015;Yamada et al, 2017b;Charususin et al, 2018;Jaitovich and Barreiro, 2018;Lee and Kim, 2019) and will finally Correlation analysis of FEV1/FVC% predicted values and bilateral total diaphragmatic motion excursions during forced breathing.…”

Section: Discussionmentioning

confidence: 99%

“…The inflammatory cytokines produced by COPD severely affect skeletal muscles throughout the whole body, including the diaphragm. In addition, tissue insufficient oxygen supply, electrolytic disorder further damages the diaphragm ( Barreiro and Gea, 2015 ; Yamada et al, 2017b ; Charususin et al, 2018 ; Jaitovich and Barreiro, 2018 ; Lee and Kim, 2019 ) and will finally cause diaphragm fatigue or even respiratory failure, which will severely reduce patient’s life quality. Previous studies mainly focused on evaluation of diaphragm morphology or functional imaging ( Kharma, 2013 ; Koo et al, 2018 ; Do Nascimento and Fleig, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of diaphragmatic motion during forced breathing in chronic obstructive pulmonary disease patients using dynamic chest radiography

Chen

Zhong²,

Wang³

et al. 2022

Front. Integr. Neurosci.

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ObjectiveTo quantitatively evaluate the bilateral diaphragmatic motion difference during forced breathing between chronic obstructive pulmonary disease (COPD) patients and healthy individuals using dynamic chest radiography technique.MethodsThis prospective study included the COPD patients (n: 96, f/m: 17/79, age: 66 ± 8 years old) and healthy individuals (n: 50, f/m: 42/8, age: 53 ± 5 years old) that underwent dynamic chest radiography with a flat panel X-ray detector system during forced breathing in a standing position. After analyzing the excursions, duration and velocity of diaphragmatic motion were automatically calculated using the postprocessing software. The parameters of diaphragmatic motion including excursion, duration, velocity, inhalation/exhalation times were assessed in all subjects for both diaphragms. The correlation between lung function parameters and diaphragmatic motion excursions were further evaluated.ResultsThe excursions of diaphragmatic motion in COPD patients were significantly decreased in COPD patients compared with healthy individuals during forced breathing (P < 0.05). The excursion in COPD patients was 35.93 ± 13.07 mm vs. 41.49 ± 12.07 mm in healthy individuals in the left diaphragm, and 32.05 ± 12.29 mm in COPD patients vs. 36.88 ± 10.96 mm in healthy individuals in the right diaphragm. The duration of diaphragmatic motion significantly decreased in COPD patients, compared with the healthy individuals (P < 0.05). The inhalation time in COPD patients was 2.03 ± 1.19 s vs. 2.53 ± 0.83 s in healthy individuals in the left diaphragm and 1.94 ± 1.32 s in COPD patients vs. 2.23 ± 1.21 s in healthy individuals in the right diaphragm. The exhalation time was 4.77 ± 1.32 s in COPD patients vs. 6.40 ± 2.73 s in healthy individuals in the left diaphragm and 4.94 ± 3.30 s in COPD patients vs. 6.72 ± 2.58 s in healthy individuals in the right diaphragm. The peak velocity of diaphragmatic motion showed no significant difference between COPD and healthy groups. The excursions of bilateral diaphragmatic motion showed moderate correlation with FEV1/FVC (r = 0.44, P < 0.001). Multi-linear regression analysis showed that the excursions of bilateral diaphragm are significantly associated with COPD occurrence (P < 0.05).ConclusionThe excursions and duration of diaphragmatic motion during forced breathing are significantly decreased in COPD patients, compared with healthy individuals. Our study showed that precise bilateral diaphragmatic motion activity can be evaluated by dynamic chest radiography.

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“…After the respiratory rehabilitation program, the mean dyspnea scores of the experimental and control groups were different, with statistical significance, possibly because pursed lip breathing and breathing by using abdominal or diaphragm muscles helped to increase tracheal pressure when breathing [24,25]. This helped to resist pressure from lung tissues, thereby delaying trachea deflation, increasing ventilation and gas exchange in air bags, causing patients with lung cancer in the experimental group to breathe conveniently and have reduced dyspnea [26,27]. Breathing exercises helped the participants relax.…”

Section: Dyspneamentioning

confidence: 98%

The Effects of the Respiratory Rehabilitation Program on Perceived Self-Efficacy and Dyspnea in Patients with Lung Cancer

Saetan

Chaiviboontham

Pokpalagon

et al. 2020

Asian Nursing Research

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This study aims to examine the effects of the respiratory rehabilitation program on perceived self-efficacy and dyspnea in patients with lung cancer. Methods: This is a quasi-experimental research study with a two-group repeated measures design with the pretest and post-test at Week 4 and Week 8. The theory of self-efficacy by Bandura was used as the conceptual framework. The sample consisted of patients with nonesmall-cell lung cancer Stage 4 who visited the oncology clinic in a university hospital. Twenty-eight patients were enrolled and equally allocated to the control group and experimental group. The control group received routine nursing care only, whereas the experimental group received the respiratory rehabilitation program. The program comprised dyspnea educating, breathing exercise, using handheld fans, effective coughing, respiratory strengthening training, and follow-up by phone in the third and sixth week. Data for perceived selfefficacy and dyspnea were collected before the program start and reassessment in the fourth and eighth week. Instrumentation was composed of the respiratory rehabilitation program, demographic data, perceived self-efficacy assessment for respiratory rehabilitation, and the Cancer Dyspnea Scale. Data were analyzed using descriptive statistics and one-factor repeated measures analysis of variance and by comparing means between groups. Results: The result revealed that almost all of the patients in the sample were men, and the mean age of the experimental group and control group was 65.80 years (standard deviation ¼ 8.80) and 73.00 years (standard deviation ¼ 7.60), respectively. There was significant different in the mean score of perceived self-efficacy and dyspnea between the experimental group and the control group (p < .050). Conclusion:Based on the findings of the study, the respiratory rehabilitation program should be used to promote self-efficacy and relieve dyspnea in patients with lung cancer.

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Meta-analysis of the Effect of a Pulmonary Rehabilitation Program on Respiratory Muscle Strength in Patients with Chronic Obstructive Pulmonary Disease

Cited by 16 publications

References 23 publications

Effects of continuous aerobic training associated with resistance training on maximal and submaximal exercise tolerance, fatigue, and quality of life of patients post‐COVID‐19

Effects of continuous aerobic training associated with resistance training on maximal and submaximal exercise tolerance, fatigue, and quality of life of patients post‐COVID‐19

Quantitative evaluation of diaphragmatic motion during forced breathing in chronic obstructive pulmonary disease patients using dynamic chest radiography

The Effects of the Respiratory Rehabilitation Program on Perceived Self-Efficacy and Dyspnea in Patients with Lung Cancer

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